The joy of 24-year-old Heather Manista’s life is playing with her 16-month-old son Colten, at her home in Berea. But her path to motherhood has been a struggle. During the 5 years Manista battled a heroin addiction, she overdosed 12 times.

"The first time I ever tried heroin, I shot it," Manista said. "I guess death didn’t really scare me. I was just doing whatever, you know? And then I found out I was pregnant, and that’s when everything changed."

To keep her newborn from going into foster care, Manista had to get sober. She was able to get help through child welfare services, which paired her with an innovative program known as START. In Cuyahoga County, the START program aims to help pregnant women or women with young children in the child welfare system who are struggling with substance abuse to get into treatment. There are some 472 families currently involved in the program.

Mothers are referred to the START program through child services, often due to being reported for suspected child abuse or neglect, or for testing positive for drugs while pregnant. Other mothers, like Manista, ask for help themselves. The goal is to keep families together, and to stem the skyrocketing rates of children going into foster care due to the opioid epidemic.

Sitting on the couch with Manista and her son, Vivette Evans checks up on the family. Perhaps the most innovative aspect of START is the family advocacy, or peer mentor program. Advocates like Evans are recovering addicts themselves, and paired with the parent as a mentor to help walk them through treatment.

"At a young age I was introduced to alcohol and from that point I became a follower," Evans said. "I got into taking pills, then I started with the crack cocaine. The alcohol was always present. And that’s what almost ended my life."

Evans got sober in 2004, and has been clean for 14 years. Since becoming a family advocate 4 years ago, she’s been able to use her own experience with addiction to help others. Family advocates can often build a rapport different from a caseworker.

"When they look at you and say okay, well you've been where I’m at, so you get it," Evans said. "They don’t open up a lot of times to the worker, because they’re ashamed or they feel like someone’s going to look down upon them. But I always tell them, I’m reaching my hand out to pull you up, cuz I’ve been there."

Family advocates visit their clients at home, provide transportation when needed, or accompany them to appointments or drug court.

"The role of that person within this program is to walk with the parent through their recovery process, through the child welfare process, and say hey, I was where you were, I know what you’re going through, I got through it, and you can too," said Fawn Gadel, the director of the START pilot program at Public Children Services Association of Ohio in Columbus, an organization that advocates for child welfare services. "And that really seems to be the game changer in this program. It makes the difference."

The START program has been in Cuyahoga County for over two decades, and in 2017 the state expanded the program to 16 counties in southern Ohio.

"Right now we’re concentrating on getting these 16 counties up and running, and going, but in the next few years we would like to see this program expand to other counties that are interested," Gadel added.

The new expanded program also borrows from a model in Kentucky, which research has shown to be successful.

"For moms that enroll in START, they become sober at twice the rate as moms that do not," Gadel said. "Kids are twice as unlikely to enter into foster care as those that do not. And for every dollar that they spend for Kentucky START, they are saving $2.22 in placement costs. So we believe that this is going to hopefully have very similar results in Ohio."

Meanwhile, back at her home in Berea, Heather Manista feels confident and excited about her new life, and is now expecting her second child. Manista will stay with the START program, as well as be paired with a caseworker from child services again, in an effort to stay clean and maintain custody of her kids.

As for Vivette Evans, being able to walk beside her clients as they get to recovery is always a positive moment for her.

"Recovery is beautiful. It really is," said Evans. "That’s why recovery I think of is like a butterfly. When a butterfly emerges from its cocoon, it’s so beautiful. And that’s what recovery is, it changes your whole life."

For Manista, recovery means the chance to rebuild a new life with her soon-to-be-daughter, and her son Colten.

"My biggest fear is him hating me for what I've done in my past," Manista said. "So I want to correct it and teach him, like yes, I have done this in the past. But mommy's better now. Mommy's in recovery, Mommy's doing this stuff and I have to keep doing it. It's an everyday thing, and I'm fighting not only for myself but for him too."